US8409200B2 - Surgical grasping device - Google Patents

Abstract

A surgical device comprising a clevis defining a longitudinal axis and a jaw comprising a first member and a second member. A slider is slidably engaged to the clevis, the slider comprising a pin. The pin is receiveably engaged in the first slot and the jaw is selectively moveable between a first position and a second position through longitudinal movement of the slider. In various embodiments, the first and second members are movable between an angular open position, a parallel open position, and a parallel closed position.

Description

BACKGROUND

In laparoscopic surgical procedures, a small incision is made in the body and an elongate shaft of a surgical device is inserted through the incision to position a distal end of the shaft at a surgical site. In endoscopic procedures, the elongate shaft of a surgical device is inserted through a natural orifice, such as the mouth or anus, and is advanced along a pathway to position a distal end of the device at a surgical site. Endoscopic procedures typically require the use of a flexible shaft to accommodate the tortuous pathway of the body lumen, whereas rigid shafts can be used in laparoscopic procedures. These tools can be used to engage and/or treat tissue in a number of ways to achieve a diagnostic or therapeutic effect.

Often during laparoscopic and endoscopic procedures, a surgeon must grasp, ablate, manipulate, dissect, or clamp soft tissue. Such actions may be performed using a plier-like tool, such as a hemostat or forceps. In some circumstances, the working end of the tool includes a first electrode and a second electrode, where one of the electrodes is brought into close opposition to the other electrode, thereby allowing an electrical current to pass between the two conductive elements. When soft tissue is captured between the two electrodes, the flowing current can cauterize, vaporize, and/or otherwise treat the soft tissue. Previous bipolar forceps, referring to U.S. Pat. No. 5,944,718, the entire disclosure of which is hereby incorporated be reference herein, have included a first electrode which can be angularly pivoted relative to a stationary second electrode. These forceps have further included a first wire attached to the first electrode where the first wire is configured to supply current to the first electrode from an electrical source. In addition, these forceps have included a second wire which is attached to the second electrode where the second wire is configured to complete the electrical circuit and return the current back to the electrical source. In some circumstances the working end of the tool includes a cutting end with a first blade member and second blade member to allow for the cutting, severing, or dissection of soft tissue. In some circumstances the working end of the tool includes a plurality of teeth to assist in the gripping of tissue.

Generally, these laparoscopic and endoscopic devices require a linkage associated with the working end of the devices which allows for user-controlled operation. The linkage allows the user to move the jaws of the working end between an open position and a closed position. An open position is when the jaws are disposed in spaced relation to one another and a closed position is wherein the jaw members cooperate to grasp tissue therebetween. These linkages used to control the movement of the jaws can often be complex requiring a multitude of small components. Additionally, in some circumstances, such linkages may not provide the desired clamping force or opening force during surgical procedures.

Accordingly, there remains a need for improved methods and devices for controlling actuation of a working end of a surgical device.

FIGURES

The novel features of the various embodiments are set forth with particularity in the appended claims. The various embodiments, however, both as to organization and methods of operation may best be understood by reference to the following description, taken in conjunction with the accompanying drawings as follows.

FIG. 1 is a perspective view of one embodiment of a surgical grasping device.

FIG. 2 is a perspective view of one embodiment of a system comprising the surgical grasping device shown inFIG. 1.

FIG. 2A illustrates an embodiment with a surgical grasping device protruding from the working channel of an endoscope.

FIG. 3 illustrates one embodiment of a bottom jaw of the surgical grasping device shown inFIG. 1.

FIG. 4 illustrates one embodiment of a top jaw of the surgical grasping device shown inFIG. 1.

FIG. 5 illustrates one embodiment of a slider of the surgical grasping device shown inFIG. 1.

FIG. 6 is a side view of one embodiment of the surgical grasping device shown inFIG. 1.

FIG. 6ais a cross-sectional view of one embodiment of the surgical grasping device shown inFIG. 6 taken along the longitudinal axis.

FIG. 7 is a side view of one embodiment of the surgical grasping device shown inFIG. 1 during actuation.

FIG. 7ais a cross-sectional view of one embodiment of the surgical grasping device shown inFIG. 7 taken along the longitudinal axis.

FIG. 8 is a side view of one embodiment of the surgical grasping device shown inFIG. 1 during actuation.

FIG. 8ais a cross-sectional view of one embodiment of the surgical grasping device shown inFIG. 8 taken along the longitudinal axis.

FIG. 9 is a perspective view of one embodiment of a surgical grasping device.

FIG. 10 is a perspective view of one embodiment of a surgical grasping device.

FIG. 11 is a perspective view of a system comprising the surgical grasping device shown inFIG. 10.

FIG. 12 illustrates one embodiment of a bottom jaw of the surgical grasping device shown inFIG. 10.

FIG. 13 illustrates one embodiment of a top jaw of the surgical grasping device shown inFIG. 10.

FIG. 14 illustrates one embodiment of a slider of the surgical grasping device shown inFIG. 10.

FIG. 15 is a side view of one embodiment of the surgical grasping device shown inFIG. 10.

FIG. 15ais a cross-sectional view of one embodiment of the surgical grasping device shown inFIG. 15 taken along the longitudinal axis.

FIG. 16 is a side view of one embodiment of the surgical grasping device shown inFIG. 9 during actuation.

FIG. 16ais a cross-sectional view of one embodiment of the surgical grasping device shown inFIG. 16 taken along the longitudinal axis.

FIG. 17 is a side view of one embodiment of the surgical grasping device shown inFIG. 9 during actuation.

FIG. 17ais a cross-sectional view of one embodiment of the surgical grasping device shown inFIG. 17 taken along the longitudinal axis.

FIG. 18 is a perspective view of one embodiment of a surgical grasping device.

FIG. 19 is a perspective view of one embodiment of a system comprising the surgical grasping device shown inFIG. 18.

FIG. 20 illustrates one embodiment of a bottom jaw of the surgical grasping device shown inFIG. 18.

FIG. 21 illustrates one embodiment of a top jaw of the surgical grasping device shown inFIG. 18.

FIG. 22 illustrates one embodiment of a slider of the surgical grasping device shown inFIG. 18.

FIG. 23 is a side view of one embodiment of the surgical grasping device shown inFIG. 18.

FIG. 23ais a cross-sectional perspective view of one embodiment of the surgical grasping device shown inFIG. 23 taken along the longitudinal axis.

FIG. 24 is a side view of one embodiment of the surgical grasping device shown inFIG. 18 during actuation.

FIG. 24ais a cross-sectional perspective view of one embodiment of the surgical grasping device shown inFIG. 24 taken along the longitudinal axis.

FIG. 25 is a side view of one embodiment of the surgical grasping device shown inFIG. 18 during actuation.

FIG. 25ais a cross-sectional perspective view of one embodiment of the surgical grasping device shown inFIG. 25 taken along the longitudinal axis.

FIGS. 26a-bare perspective views of one embodiment of a surgical grasping device.

FIGS. 27a-billustrate one embodiment of a bottom jaw of the surgical grasping device shown inFIGS. 26a-b.

FIGS. 28a-billustrate one embodiment of a bottom jaw of the surgical grasping device shown inFIGS. 26a-b.

FIGS. 29a-billustrate one embodiment of a slider of the surgical grasping device shown inFIGS. 26a-b.

FIGS. 30a-cillustrate one embodiment of a linkage of the surgical grasping device shown inFIGS. 26a-b.

FIGS. 31a-billustrate one embodiment of a clevis of the surgical grasping device shown inFIGS. 26a-b.

FIGS. 32a-billustrate one embodiment of a slot configuration on the clevis shown inFIGS. 31a-b.

FIG. 33 is a side view of one embodiment of the surgical grasping device shown inFIGS. 26a-b.

FIG. 33ais a cross-sectional view of one embodiment of the surgical grasping device shown inFIG. 33 taken along the longitudinal axis.

FIG. 34 is a side view of one embodiment of the surgical grasping device shown inFIGS. 26a-b.

FIG. 34ais a cross-sectional view of one embodiment of the surgical grasping device shown inFIG. 34 taken along the longitudinal axis.

FIG. 35 is a side view of one embodiment of the surgical grasping device shown inFIGS. 26a-b.

FIG. 35ais a cross-sectional view of one embodiment of the surgical grasping device shown inFIG. 35 taken along the longitudinal axis.

FIG. 36 is a side view of one embodiment of the surgical grasping device shown inFIGS. 26a-b.

FIG. 36ais a cross-sectional view of one embodiment of the surgical grasping device shown inFIG. 36 taken along the longitudinal axis.

FIG. 37 is a side view of one embodiment of the surgical grasping device shown inFIGS. 26a-b.

FIG. 37ais a cross-sectional view of one embodiment of the surgical grasping device shown inFIG. 37 taken along the longitudinal axis.

FIG. 38 illustrates an isometric view of the surgical device shown inFIGS. 26a-bablating tissue.

FIG. 39 illustrates an isometric view of the surgical device shown inFIGS. 26a-bablating tissue.

FIG. 40 illustrates an isometric view of the surgical device shown inFIGS. 26a-bablating tissue.

DESCRIPTION

The various embodiments described herein are directed to actuating surgical devices, including cutting devices, grasping devices and electrical therapy ablation devices. The electrical therapy ablation devices comprise electrodes that can be positioned in or in proximity to a tissue treatment region (e.g., target site) within a patient endoscopically, transcutaneously (percutaneously), or laparoscopically and, in some embodiments, any combination thereof. In at least one form of the invention, a bipolar forceps can include two or more electrodes wherein the electrodes can be positioned against, or adjacent to, a vessel, such as a blood vessel, for example, and energy can be supplied to the electrodes. In various circumstances, the energy can be sufficient to at least substantially seal the vessel such that blood does not substantially flow therethrough. In at least one surgical technique, the bipolar forceps can be used to seal the vessel in two locations such that the vessel can be incised, or transected, at a location positioned intermediate the two seal locations. In at least one embodiment, the bipolar forceps can include a cutting element which can be configured to incise the vessel. In various embodiments, the cutting element can include a sharp edge which can be moved relative to the vessel. In at least one embodiment, the cutting element can be electrically connected to a source of energy wherein the energized cutting element can be configured to incise the tissue.

In at least one form of the invention, a bipolar forceps can include first and second electrodes positioned within first and second jaw members, respectively, wherein at least one of the jaw members can include a substantially tapered profile. In various surgical techniques, the jaw members can be positioned in a substantially closed position such that the distal end of the jaw members can be positioned intermediate a vessel, for example, and tissue at least partially surrounding the vessel. Thereafter, in at least one surgical technique, the jaw members can be opened in order to pull the vessel away from the soft tissue. In various techniques, the jaw members can be opened and closed repeatedly to enlarge a hole between the vessel and the tissue and/or otherwise separate the vessel from the tissue. In at least one embodiment, at least one of the jaw members can include ridges, teeth, and/or a textured outer surface configured to grip the soft tissue and/or vessel.

Once positioned, the electrical therapy electrodes are adapted to deliver energy, for example in the form of electrical current, to the treatment region. The electrical current may be generated by a control unit or generator located external to the patient. The electrical current may be characterized by a particular waveform in terms of frequency, amplitude, polarity, and pulse width. Depending on the diagnostic or therapeutic treatment rendered, the surgical device may comprise one electrode containing both a cathode and an anode or may contain a plurality of electrodes with at least one serving as a cathode and at least one serving as an anode. Depending on the diagnostic or therapeutic treatment rendered, the diseased tissue can be electrically ablated or destroyed. More particularly, the electrical therapy ablation devices may be employed to deliver sufficient energy to the diseased tissue to ablate or destroy tumors, masses, lesions, and other abnormal tissue growths. In at least one embodiment, the electrical therapy ablation devices and techniques described herein may be employed in the treatment of cancer by quickly creating necrosis and destroying live cancerous tissue in-vivo. Such devices and techniques are further described in a commonly-owned, U.S. patent application Ser. No. 11/897,676, entitled ELECTRICAL ABLATION SURGICAL INSTRUMENTS, filed on Aug. 31, 2007, published as United States Patent Application Publication No. 2009/0062788, the entire disclosure of which is hereby incorporated by reference herein.

Electrical therapy ablation may employ electroporation or electropermeabilization techniques where an externally applied electric field (electric potential) significantly increases the electrical conductivity and permeability of a cell plasma membrane. Electroporation is the generation of a destabilizing electric potential across such biological membranes. In electroporation, pores are formed when the voltage across the cell plasma membrane exceeds its dielectric strength. Electroporation destabilizing electric potentials are generally in the range of several hundred volts across a distance of several millimeters. Below certain magnitude thresholds, the electric potentials may be applied across a biological membrane as a way of introducing some substance into a cell, such as loading it with a molecular probe, a drug that can change the function of the cell, a piece of coding DNA, or increasing the uptake of drugs in cells. If the strength of the applied electrical field and/or the duration of exposure to it are suitably chosen, the pores formed by the electrical pulse reseal after a short period of time, during which period extracellular compounds may enter into the cell. Below a certain field threshold, the process is reversible and the potential does not permanently damage the cell membrane. This process may be referred to as reversible electroporation (RE).

On the other hand, excessive exposure of live cells to large electric fields can cause apoptosis and/or necrosis—the processes that result in cell death. Excessive exposure of live cells to large excessive electrical fields or potentials across the cell membranes causes the cells to die and therefore may be referred to as irreversible electroporation (IRE).

Electroporation may be performed with devices called electroporators. These appliances create the electric current and send it through the cell. Electroporators may comprise two or more metallic (e.g., aluminum) electrically conductive electrodes connected to an energy source. The energy source generates an electric field having a suitable characteristic waveform output in terms of frequency, amplitude, polarity, and pulse width.

Endoscopy refers to looking inside the human body for medical reasons. Endoscopy may be performed using an instrument called an endoscope. Endoscopy is a minimally invasive diagnostic medical procedure used to evaluate the interior surfaces of an organ by inserting a small tube into the body, often, but not necessarily, through a natural body opening or through a relatively small incision. Through the endoscope, an operator may observe surface conditions of the organs, including abnormal or diseased tissue such as lesions and other surface conditions. The endoscope may have a rigid or a flexible tube and in addition to providing an image for visual inspection and photography, the endoscope may be adapted and configured for taking biopsies, retrieving foreign objects, and introducing medical instruments to a tissue treatment region referred to as the target site. Endoscopy is a vehicle for minimally invasive surgery.

Laparoscopic surgery is a minimally invasive surgical technique in which operations in the abdomen are performed through small incisions (usually 0.5-1.5 cm), keyholes, as compared to larger incisions needed in traditional surgical procedures. Laparoscopic surgery includes operations within the abdominal or pelvic cavities, whereas keyhole surgery performed on the thoracic or chest cavity is called thoracoscopic surgery. Laparoscopic and thoracoscopic surgery belong to the broader field of endoscopy.

A key element in laparoscopic surgery is the use of a laparoscope: a telescopic rod lens system that is usually connected to a video camera (single-chip or three-chip). Also attached is a fiber-optic cable system connected to a “cold” light source (halogen or xenon) to illuminate the operative field, inserted through a 5 mm or 10 mm cannula to view the operative field. The abdomen is usually insufflated with carbon dioxide gas to create a working and viewing space. The abdomen is essentially blown up like a balloon (insufflated), elevating the abdominal wall above the internal organs like a dome. Carbon dioxide gas is used because it is common to the human body and can be removed by the respiratory system if it is absorbed through tissue.

The embodiments of the actuating cutting, dissecting, and electrical therapy ablation devices and techniques described herein may be employed to treat diseased tissue, tissue masses, tissue tumors, and lesions (diseased tissue) at a tissue treatment region (target site) within the body. Minimally invasive therapeutic procedures to treat diseased tissue by introducing medical instruments to a tissue treatment region through a natural opening of the patient are known as Natural Orifice Translumenal Endoscopic Surgery (NOTES)™.

FIG. 1 illustrates one embodiment of asurgical device10.Surgical device10 may be employed to treat diseased tissue such as tumors and lesions inside a patient with electrical energy or otherwise dissect, cut, or manipulate tissue.Surgical device10 may be used to treat the desired tissue treatment region in minimally invasive, open, or noninvasive surgical procedures. Minimally invasive surgical procedures include, for example, endoscopic, laparoscopic, thoracoscopic, or other surgical procedures that require small incisions or keyholes.Surgical device10 also may be used in traditional open laparotomy procedures as well as external noninvasive procedures to treat diseased tissue outside the body. In one embodiment,surgical device10 may be configured to be positioned within a natural opening of the patient such as the mouth, anus, vagina, or colon and subsequently advanced and positioned within internal body lumens such as the esophagus and/or uterus to reach the tissue treatment region or target site. Internal organs may be reached using trans-organ or trans-luminal surgical procedures.Surgical device10 also may be configured to be positioned through a small incision or keyhole on the patient and can be passed through the incision to reach a tissue treatment region or target site through a trocar. The tissue treatment region may be located in various body lumens or organs such as the esophagus, stomach, colon, liver, breast, brain, lung, and other organs or locations within the body.Surgical device10 can be configured to treat a number of lesions and ostepathologies comprising metastatic lesions, tumors, fractures, infected sites, inflamed sites, and the like. Once positioned in the tissue treatment region,surgical device10 can be configured to treat and ablate the diseased tissue in that region. In one embodiment,surgical device10 may be adapted to treat diseased tissue, such as cancers, of the gastrointestinal (GI) tract, esophagus, or lung that may be accessed orally. In another embodiment,surgical device10 may be adapted to treat diseased tissue, such as cancers, of the liver or other organs that may be accessible trans-anally through the colon and/or the abdomen via well-known procedures.

In one embodiment,surgical device10 may be employed in conjunction with a flexible endoscope, such as the GIF-100 model available from Olympus Corporation. The flexible endoscope may be introduced into the patient trans-anally through the colon, orally through the esophagus, vaginally through the uterus, or the abdomen via an incision or keyhole and a trocar, for example. The endoscope assists the surgeon to guide and position thesurgical device10 near the tissue treatment region to treat diseased tissue in various body lumens and organs such as the esophagus, stomach, colon, liver, breast, brain, lung, and other internal tissue treatment regions.

FIG. 1 shows a perspective view of one embodiment of asurgical device10.Surgical device10 generally comprises atop jaw18, abottom jaw20, aclevis26 and aslider24. In various embodiments,top jaw18 may house atop electrode22 andbottom jaw20 may house abottom electrode28. Acoupling30 allows for the attachment ofclevis26 to ashaft16. In various embodiments coupling30 may be optionally configured to allow thesurgical device10 to rotate relative to and about a longitudinal axis “A”, thus allowingsurgical device10 to be positioned in multiple angular orientations. Some embodiments may havemultiple couplings30. Optionally,surgical device10 may, for example, be attached to a laparoscopic and endoscopic instrument. Accordingly, in various embodiments,shaft16 may be either flexible or rigid, or a combination thereof. Adriveline32 is located insideshaft16. In various embodiments,driveline32 passes through the center ofcoupling30 and is attached toslider24.Driveline32 may be coupled toslider24 using any suitable means, such as laser welding.Slider24 functions to slide on longitudinal axis “A.”

As shown inFIG. 1,surgical device10 is configured for electrical therapy ablation, but in other embodiments may be configured for cutting, dissecting, or grasping. For example,top jaw18 andbottom jaw20 may be configured with cutting blades, a plurality of teeth, or any other configuration providing the required functionality.

FIG. 2 is a perspective view ofsurgical device10 and ahandle assembly14 coupled thereto. It is understood by those skilled in the art thatsurgical device10 can be coupled to any control device, mechanical or electrical, which allows for actuation oftop jaw18 andbottom jaw20. Handleassembly14 comprises abase handle portion86, atrigger82, arotation knob84, and anopening88 to receive the proximal end ofdriveline32.Trigger82 is operatively coupled todriveline32. Whentrigger82 is pivotally moved (e.g., squeezed) in a direction indicated byarrow90,driveline32 moves in a direction indicated byarrow92, and top andbottom jaw members18,20 close in a direction indicated byarrow94. Whentrigger82 is pivotally moved (e.g., released) in a direction indicated byarrow98,driveline32 moves in a direction indicated byarrow78, and top andbottom jaw members18,20 open in a direction indicated byarrow96. The distal end ofdriveline32 is received withinrotation knob84. Whenrotation knob84 is rotated in a direction indicated byarrow74,surgical device10 also is rotated in a direction indicated byarrow4. Whenrotation knob84 is rotated in a direction indicated by arrow76,surgical device10 is also rotated in direction indicated byarrow6. In various embodiments, an energy source, such as a waveform generator (not shown), may be connected tosurgical device10 in order to provide electrical energy to any electrodes incorporated intosurgical device10.

FIG. 2A illustrates one embodimentsurgical device10 with anendoscope15. In the illustrated embodiment,surgical device10 is introduced into a workingchannel526 at the proximal end of theendoscope15. Assurgical device10 is inserted through workingchannel526,surgical device10 protrudes from a distal end ofendoscopic portion524. As shown inFIG. 2A,endoscopic portion524 may comprise alight source532, aviewing port534, and workingchannel526.Viewing port532 may transmit an image within its field of view to an optical device such as a charge coupled device (CCD) camera within theendoscope15 so that an operator may view the image on a display monitor (not shown).

FIG. 3 shows a perspective view ofbottom jaw20 of one embodiment ofsurgical device10.Jaw20 may include a plurality ofteeth50.Jaw20 also may define a cavity52 to housebottom electrode28. Arear fin54 defines ahole56 and aslot58.Hole56 is suitable to receive jaw pin60 (FIG. 1).Slot58 may extend throughrear fin54 to create an elongated opening or may only extend partially intorear fin54 to create a groove or indention inrear fin54. The shape ofslot58 may be of any desired curved, arcuate, or generally linear profile. In some embodiments,slot58 may comprise any combination of curved, arcuate, or generally linear sections in order to achieve the desired functionality (i.e., open force, close force, clamp force).

FIG. 4 shows a perspective view oftop jaw18 of one embodiment of thesurgical device10.Top jaw18 is constructed similarly tobottom jaw20.Jaw18 may include a plurality ofteeth50.Jaw18 also may define acavity64 to housetop electrode22. Arear fin66 defines ahole68 and may have aslot70.Hole68 is suitable to receive jaw pin60 (FIG. 1).Slot70 may extend throughrear fin66 to create an elongated opening or may only extend partially intorear fin66 to create a groove or indention inrear fin66. The shape ofslot70 may be of any desired profile, such as curved, arcuate, or generally linear. Whensurgical device10 is assembled,jaw pin60 is inserted throughholes56,68 to serve as a pivot point fortop jaw18 andbottom jaw20.

As shown inFIG. 5,slider24 may havetop flanges36a,36bandbottom flanges38a,38bextending from either side ofslider24.Top flange36aandbottom flange38aonfirst side40 define afirst channel41, andtop flange36bandbottom flange38bdefine asecond channel42 onsecond side44.First side40 andsecond side42 also may define afirst hole46 andsecond hole48, respectively.First hole46 andsecond hole48 are suitable to receive aslider pin47. In various embodiments,slider24 is positioned insurgical device10 such thatclevis26 is received byfirst channel41 andsecond channel42. As described in more detail below,slider24 functions to slide on longitudinal axis “A”, as shown inFIG. 1, alongclevis26.Top flanges36a,36bandbottom flanges38a,38bkeepslider24 generally affixed to clevis26 while allowing for axial movement. Sincedriveline32 is coupled toslider24, the actuation oftrigger82 also serves to moveslider24. Therefore, movement oftrigger82 is translated into longitudinal movement ofslider24 alongclevis26.

FIG. 6 is a side view of one embodiment ofsurgical device10. When assembled,jaw pin60 is inserted throughhole68 oftop jaw18 andhole56 ofbottom jaw20.Jaw pin60 serves as a pivot point during actuation oftop jaw18 andbottom jaw20.Rear fins54,66 are positioned beside each other such thatslider pin47 may extend throughfirst side40 ofslider24, throughslot70 oftop jaw18, throughslot58 ofbottom jaw20, and throughsecond side44 ofslider24.

FIGS. 6,6a,7,7a,8, and8ademonstrate a progression of the actuation of one embodiment ofsurgical device10. Referring first toFIGS. 6 and 6a, a cross-sectional perspective view of one embodiment ofsurgical device10 taken along longitudinal axis “A” ofFIG. 6,surgical device10 is shown in a “closed position.” In its closed positiontop jaw18 andbottom jaw20 are in close proximity to each other, allowing for the cutting, grasping, or ablating of tissue. In order to actuate, or open,top jaw18 andbottom jaw20, the user imparts movement todriveline32. In various embodiments, trigger82 may be used to impart such movement.Slider24 is coupled todriveline32; therefore, movement ofdriveline32 in afirst direction72 movesslider24 longitudinally infirst direction72, or toward the distal end ofsurgical device10.

FIG. 7 shows the position oftop jaw18 andbottom jaw20 afterslider24 has moved infirst direction72. By virtue of the movement ofdriveline32,slider24 has been moved longitudinally alongclevis26.FIG. 7ais a cross-sectional perspective view of one embodiment ofsurgical device10 taken along the longitudinal axis ofFIG. 7. Movement ofslider24 infirst direction72 movesslider pin47 infirst direction72. This movement ofslider pin47causes slider pin47 to travel withinslot58 ofbottom jaw20 andslot70 oftop jaw18. Due to the profile ofslots58,70,top jaw18 andbottom jaw20 pivot aboutjaw pin60 and separate from each other.

FIG. 8 shows the position oftop jaw18 andbottom jaw20 afterslider24 has moved further infirst direction72.Slider24 has been further moved longitudinally alongclevis26.FIG. 8ais a cross-sectional view of one embodiment ofsurgical device10 taken along the longitudinal axis ofFIG. 8. Due to the profile ofslots58,70,top jaw18 andbottom jaw20 pivot aboutjaw pin60 and separate further from each other. As shown,top jaw18 andbottom jaw20 are nearly at a completely opened position. Furthermore,pin47 has traveled nearly the full length ofslots58,70.

In various embodiments, other techniques may be utilized to move slider34 longitudinally alongclevis26. For instance, rotational movement ofdriveline32 may be utilized to translateslider24 along26. In one embodiment, the distal end ofdriveline32 comprises a first threaded feature that engages a second threaded feature associated withslider24. As the user rotates or twistsdriveline32, the first threaded feature on the distal end ofdriveline32 also rotates. Asdriveline32 rotates, the threaded engagement of the first and second threaded features imparts longitudinal motion to theslider24. In one embodiment, the user may lock, or selectively fix,top jaw18 andbottom jaw20 at any desired angle by impeding rotational movement ofdriveline32.

FIG. 9 shows an embodiment of the present invention which may be used for electrical ablation therapy. First and secondelectrical conductors302a,302bare electrically coupled to the respective top andbottom electrodes22,28 formed in the respective top andbottom jaw members18,20. In one embodiment,driveline32 may serve as an electrical conductor. In various embodiments, top andbottom electrodes22,28 may be formed having a substantially flat, paddle-like shape. First and secondelectrical conductors302a,302bmay be received through lumens formed inshaft16 and are coupled to top andbottom electrodes22,28 in any suitable manner. A switch may be coupled toelectrical conductors302a,302bto enable an operator to activate and deactivate top andbottom electrodes22,28 after tissue at the desired target site is grasped between respective top andbottom jaw members18,20.

Anenergy source301, such as an electrical waveform generator, is employed to energize top andbottom electrodes22,28 with an electrical energy level suitable to produce an arc betweentop electrode22 andbottom electrode28. The electric arc is suitable to ablate fibrous tissues such as adhesions growing between internal organs of a patient, for example. The input toenergy source301 is connected to a commercial power supply by way of aplug304. The output ofenergy source301 is coupled tosurgical device10 through first and secondelectrical conductors302a,302b.

In one embodiment,energy source301 comprises a timing circuit to interrupt the output ofenergy source301 and produce a cyclical pattern. The timing circuit may comprise suitable switching elements to produce a cyclical or pulsed output energy signal to drive top andbottom electrodes22,28 ofsurgical device10. For example,energy source301 may produce a series of n pulses suitable to generate the electric arc, when the pulsed energy is applied to top andbottom electrodes22,28.

In one embodiment,energy source301 comprises an electrical waveform generator to produce an electrical waveform. The electrical waveform generator produces electric potentials at predetermined frequencies, amplitudes, polarities, and pulse widths.

In one embodiment,energy source301 comprises a radio frequency (RF) generator to produce RF waveforms at predetermined frequencies, amplitudes, polarities, and pulse widths. The RF generator may be a conventional, bipolar/monopolar electrosurgical generator such as one of the many models commercially available, including Model Number ICC 350, available from Erbe, GmbH.

In one embodiment,energy source301 may be a conventional, bipolar/monopolar pulsed DC generator such as one of the many models commercially available, including Model Number ECM 830, available from BTX Molecular Delivery Systems, Boston, Mass. In bipolar mode,top electrode22 may be electrically coupled to one polarity andbottom electrode28 may be electrically coupled to the opposite polarity.

In various embodiments,energy source301 produces direct current (DC) electrical pulses delivered at frequencies in the range of 1-20 Hz, amplitudes in the range of ±100 to ≅1000 VDC, and pulse widths in the range of 0.01-100 ms. For example, an electrical waveform having an amplitude of +500 VDC and a pulse duration of 20 ms may be delivered at a pulse repetition rate or frequency of 10 HZ to ablate tissue. In one embodiment, the polarity of top andbottom electrodes22,28 may be electronically reversed. For example, the polarity of electrical pulses initially delivered at amplitudes in the range of +100 to +1000 VDC may be reversed to −100 to −1000 VDC.

FIG. 10 shows an embodiment ofsurgical device110. In various embodiments,surgical device110 may have atop jaw118 and abottom jaw120 pivotally coupled to aclevis126.Surgical device110 may further comprise aslider124 and acoupling130. Coupling130 allows for the attachment ofclevis126 to ashaft116. In various embodiments coupling130 may be optionally configured to allow thesurgical device110 to rotate relative to and about a longitudinal axis “B”, thus allowingsurgical device110 to be positioned in multiple angular orientations. Some embodiments may havemultiple couplings130. Optionally,surgical device110 may, for example, be attached to a laparoscopic and endoscopic instrument. In various embodiments,shaft116 may be rigid or flexible. Adriveline132 is located insideshaft116.Driveline132 passes through the center ofcoupling130 and is attached toslider124.Driveline132 may be coupled toslider124 using any suitable means, such as laser welding.Slider124 functions to slide on longitudinal axis “B.”

As shown inFIG. 10top jaw118 andbottom jaw120 comprise a plurality ofteeth150, but in various embodiments other jaw configurations may be used, such as scissors, or the jaw may be configured with an electrode, or plurality of electrodes, for ablation.

FIG. 11 is a perspective view ofsurgical device110 and ahandle assembly114 coupled thereto. It is understood by those skilled in the art thatsurgical device110 can be coupled to any control device, mechanical or electrical, which allows for actuation oftop jaw118 andbottom jaw120. Thehandle assembly114 comprises abase handle portion186, atrigger182, arotation knob184, and anopening188 to receive the proximal end ofdriveline132.Trigger182 is operatively coupled todriveline132. Whentrigger182 is pivotally moved (e.g., squeezed) in a direction indicated byarrow190,driveline132 moves in a direction indicated by arrow192, and top andbottom jaw members118,120 close in a direction indicated byarrow194. Whentrigger182 is pivotally moved (e.g., released) in a direction indicated byarrow198,driveline132 moves in a direction indicated byarrow178, and top andbottom jaws118,120 open in a direction indicated byarrow196. The distal end ofdriveline132 is received withinrotation knob184. Whenrotation knob184 is rotated in a direction indicated byarrow174,surgical device110 is also rotated in a direction indicated by arrow104. Whenrotation knob184 is rotated in a direction indicated by arrow176,surgical device110 is also rotated in a direction indicated by arrow106. In various embodiments, a waveform generator (not shown) may be connected tosurgical device110 in order to provide electrical energy to any electrodes incorporated intosurgical device110.

FIG. 12 shows a perspective view of one embodiment of abottom jaw120 of asurgical device110.Bottom jaw120 may include a plurality ofteeth150. Arear fin154 defines ahole156 and aslot158.Hole156 is suitable to receive jaw pin160 (FIG. 9).Slot158 may extend throughrear fin154 to create an elongated opening or may only extend partially intofin154 to create a groove or indention inrear fin154. The shape ofslot158 may be of any desired curved, arcuate, or generally linear profile. In some embodiments,slot158 may comprise any combination of curved, arcuate, or generally linear sections in order to achieve the desired functionality.

FIG. 13 shows a perspective view of one embodiment of atop jaw118.Top jaw118 is constructed similarly tobottom jaw120.Jaw118 may include a plurality ofteeth150. Arear fin166 defines ahole168 and may have aslot170.Hole168 is suitable to receive jaw pin160 (FIG. 10).Slot170 may extend throughrear fin166 to create an elongated opening or may only extend partially intofin166 to create a groove or indention inrear fin166. The shape ofslot170 may be of any desired curved, arcuate, or generally linear profile. In some embodiments,slot170 may comprise any combination of curved, arcuate, or generally linear sections in order to achieve the desired functionality. Whensurgical device110 is assembled,jaw pin160 is inserted throughholes156,168 to serve as a pivot point fortop jaw118 andbottom jaw120.

As shown inFIG. 14,slider124 may havetop flanges136a,136bandbottom flanges138a,138bextending from either side ofslider124.Top flange136aandbottom flange138aonfirst side140 define afirst channel141, andtop flange136bandbottom flange138bdefine asecond channel142 onsecond side144.First side140 andsecond side142 may also define afirst hole146 andsecond hole148, respectively.First hole146 andsecond hole148 are suitable to receive aslider pin147. In various embodiments,slider124 is positioned insurgical device110 such thatclevis126 is received byfirst channel141 andsecond channel142. As described in more detail below,slider124 functions to slide on a longitudinal axis “B”, shown inFIG. 10, alongclevis126.Top flanges136a,136bandbottom flanges138a,138bkeepslider124 generally affixed toclevis126. Sincedriveline132 is coupled toslider124, the actuation oftrigger182 also serves to moveslider124. Therefore, movement oftrigger182 is translated into longitudinal movement ofslider124 alongclevis126.

FIG. 15 is a side view of one embodiment ofsurgical device110. When assembled,jaw pin160 is inserted throughhole168 oftop jaw118 andhole156 ofbottom jaw120.Jaw pin160 serves as a pivot point during actuation oftop jaw118 andbottom jaw120.Rear fin154 andrear fin166 are positioned beside each other such thatslider pin147 may extend throughfirst side140 ofslider124, throughslot170 oftop jaw118, throughslot158 ofbottom jaw120, and throughsecond side144 ofslider124.

FIGS. 15,15a,16,16a,17, and17ademonstrate a progression of the actuation of one embodiment ofsurgical device110. Referring first toFIGS. 15 and 15a, a cross-sectional view of one embodiment ofsurgical device110 taken along the longitudinal axis ofFIG. 15,surgical device110 is shown in a “closed position.” In its closed positiontop jaw118 andbottom jaw120 are in close proximity to each other, allowing for the cutting, grasping, or ablating of tissue. In order to actuate, or open,top jaw118 andbottom jaw120, the user imparts movement todriveline132. In various embodiments, trigger182 may be used to impart such movement.Slider124 is coupled todriveline132; therefore, movement ofdriveline132 in afirst direction172 movesslider124 longitudinally infirst direction172, or toward the distal end ofsurgical device110.

FIG. 16 shows the position oftop jaw118 andbottom jaw120 afterslider124 has moved infirst direction172. By virtue of the movement ofdriveline132,slider124 has been moved longitudinally alongclevis126.FIG. 16ais a cross-sectional perspective view of one embodiment ofsurgical device110 taken along the longitudinal axis ofFIG. 16. Movement ofslider124 infirst direction172 movesslider pin147 infirst direction172. This movement ofslider pin147 causesslider pin147 to travel withinslot158 ofbottom jaw120 and slot170 oftop jaw118. Due to the profile ofslots158,170,top jaw118 andbottom jaw120 pivot aboutjaw pin160 and separate from each other. The profile ofslot170 and slot148 allow for greater opening force during operation. Those skilled in the art will appreciate that different slot profiles will allow for different opening and closing force characteristics, or force profiles, for various embodiments.

FIG. 17 shows the position oftop jaw118 andbottom jaw120 afterslider124 has moved further infirst direction172.Slider124 has been moved longitudinally further alongclevis126.FIG. 17ais a cross-sectional perspective view of one embodiment ofsurgical device110 taken along the longitudinal axis ofFIG. 17. Due to the profile ofslots158,170,top jaw118 andbottom jaw120 pivot aboutjaw pin160 and separate further from each other. As shown,top jaw118 andbottom jaw120 are nearly at a completely opened position. Furthermore,pin147 has traveled nearly the full length ofslots158,170.

FIG. 18 shows one embodiment ofsurgical device210. In various embodiments,surgical device210 may have atop jaw218 and abottom jaw220 pivotally coupled to aclevis226.Surgical device210 may further comprise aslider224 and acoupling230. Coupling230 allows for the attachment ofclevis226 toshaft216. In various embodiments coupling130 may be optionally configured to allow thesurgical device110 to rotate relative to and about a longitudinal axis “C”, thus allowingsurgical device110 to be positioned in multiple angular orientations. Some embodiments may havemultiple couplings130. Optionally,surgical device210 may, for example, be attached to a laparoscopic and endoscopic instrument. In various embodiments,shaft216 made be flexible or rigid, or a combination thereof. Adriveline232 is located insideshaft216. In various embodiments,driveline232 passes through the center ofcoupling230 and is attached toslider224.Driveline232 may be coupled toslider224 using any suitable means, such as laser welding.Slider224 functions to slide on longitudinal axis “C.”

As the user squeezes trigger282 (FIG. 19),driveline232 is moved longitudinally insideshaft216.

As shown inFIG. 18,top jaw218 andbottom jaw220 may comprise a plurality ofteeth250, but in various embodiments other jaw configurations may be used, such as scissors, or the jaw may be configured with an electrode, or plurality of electrodes, for ablation.

FIG. 19 is a perspective view ofsurgical device210 and ahandle assembly214 coupled thereto. It is understood by those skilled in the art thatsurgical device210 can be coupled to any control device, mechanical or electrical, which allows for actuation oftop jaw218 andbottom jaw220. Thehandle assembly214 comprises abase handle portion286, atrigger282, arotation knob284, and anopening288 to receive the proximal end ofdriveline232.Trigger282 is operatively coupled todriveline232. Whentrigger282 is pivotally moved (e.g., squeezed) in a direction indicated byarrow290,driveline232 moves in a direction indicated byarrow292, and top andbottom jaw members218,220 close in a direction indicated byarrow294. Whentrigger282 is pivotally moved (e.g., released) in a direction indicated byarrow298,driveline232 moves in a direction indicated byarrow278, and top andbottom jaw members218,220 open in a direction indicated byarrow296. The distal end ofdriveline232 is received withinrotation knob284. Whenrotation knob284 is rotated in a direction indicated byarrow274,surgical device210 also is rotated in a direction indicated byarrow204. Whenrotation knob284 is rotated in a direction indicated by arrow276,surgical device210 is also rotated in a direction indicated byarrow206. In various embodiments, a waveform generator (similar toenergy source301 shown inFIG. 9) may be connected tosurgical device210 in order to provide electrical energy to any electrodes incorporated intosurgical device210.

FIG. 20 shows a perspective view of one embodiment ofbottom jaw220 ofsurgical device210.Bottom jaw220 may include a plurality ofteeth250. Arear fin254 defines ahole256, afirst slot258, and asecond slot259.Hole256 is suitable to receive first jaw pin260 (FIG. 17), andsecond slot259 is suitable to receive second jaw pin261 (FIG. 17).First slot258 andsecond slot259 may extend throughrear fin254 to create elongated openings or may only extend partially intofin254 to create a groove or indention inrear fin254. In various embodiments, one slot may extend throughrear fin254 while the other slot only extends partially throughfin254.First slot258 andsecond slot259 may be of any desired curved, arcuate, or generally linear profile. In some embodiments,slots258,259 may comprise any combination of curved, arcuate, or generally linear sections in order to achieve the desired functionality.

FIG. 21 shows a perspective view oftop jaw218 in accordance with various embodiments of the present invention.Top jaw218 is constructed similarly tobottom jaw220.Top jaw218 may include a plurality ofteeth250. A rear fin266 defines ahole268 and may have afirst slot270 and asecond slot271.Hole268 is suitable to receive second jaw pin261 (FIG. 17), andsecond slot271 is suitable to receive first jaw pin260 (FIG. 17).First slot270 andsecond slot271 may extend through rear fin266 to create elongated openings or may only extend partially into fin266 to create a groove or indention in rear fin266. In various embodiments, one slot may extend through rear fin266, while the other slot only extends partially through rear fin266.First slot270 andsecond slot271 may be of any desired curved, arcuate, or generally linear profile. In some embodiments,slots270,271 may comprise any combination of curved, arcuate, or generally linear sections in order to achieve the desired functionality.

As shown inFIG. 22slider224 may havetop flanges236a,236bandbottom flanges238a,238bextending from either side ofslider224.Top flange236aandbottom flange238aonfirst side240 define afirst channel241 andtop flange236bandbottom flange238bdefine asecond channel242 onsecond side244. Atop post280 and abottom post282 may extend perpendicularly from afront face284 ofslider224. In various embodiments, atop pin286 may extend perpendicularly fromtop post280, and abottom pin288 may extend perpendicularly frombottom post282. In various embodiments,slider224 is positioned insurgical device210 such thatclevis226 is received byfirst channel241 andsecond channel242. As described in more detail below,slider224 functions to slide in a longitudinal axis “C” (shownFIG. 17) alongclevis226.Top flanges236a,236bandbottom flanges238a,238bkeepslider224 generally affixed toclevis226. Sincedriveline232 is coupled toslider224, the actuation oftrigger282 also serves to moveslider224. Therefore, movement oftrigger282 is translated into longitudinal movement ofslider224 alongclevis226.

FIG. 23 is a side view of one embodiment ofsurgical device210. When assembled, in various embodiments,second jaw pin261 is inserted throughhole268 oftop jaw218 andsecond slot259 ofbottom jaw220.First jaw pin260 is inserted intohole256 ofbottom jaw220 andsecond slot271 oftop jaw218.Rear fin254 and rear fin266 are positioned beside each other such thattop pin286 may be received byfirst slot258 ofbottom jaw220 andbottom pin288 may be received byfirst slot270 oftop jaw218.

FIGS. 23,23a,24,24a,25, and25ademonstrate a progression of the actuation ofsurgical device210. Referring first toFIG. 23 andFIG. 23a, a cross-sectional perspective view of one embodiment ofsurgical device210 taken along the longitudinal axis ofFIG. 23,surgical device210 is shown in a “closed position.” In its closed position,top jaw218 andbottom jaw220 are in close proximity to each other, allowing for the cutting, grasping, or ablating of tissue. In order to actuate, or open,top jaw218 andbottom jaw220, the user imparts movement todriveline232. In various embodiments, trigger282 may be used to impart such movement. Sinceslider224 is coupled todriveline232, movement ofdriveline232 in afirst direction272 movesslider224 longitudinally infirst direction272, or toward the distal end ofsurgical device210.

FIG. 24 shows the position oftop jaw218 andbottom jaw220 afterslider224 has moved infirst direction272. By virtue of the movement ofdriveline232,slider224 has been moved longitudinally alongclevis226.FIG. 24ais a cross-sectional view of one embodiment ofsurgical device210 taken along the longitudinal axis ofFIG. 24. Movement ofslider224 infirst direction272 movestop pin286 andbottom pin288 infirst direction272. This movement oftop pin286 andbottom pin288 causestop pin286 andbottom pin288 to travel withinfirst slot258 andfirst slot270, respectively. Additionally,second jaw pin261 travels withinsecond slot259 andfirst jaw pin260 travels withinsecond slot271 astop jaw218 andbottom jaw220 rotate with respect to each other. Due to the profile offirst slots258,270,top jaw218 andbottom jaw220 pivot about jaw pins260,261 and pivotally separate from each other.

FIG. 25 shows the position oftop jaw218 andbottom jaw220 afterslider224 has moved further infirst direction272.Slider224 has been moved longitudinally further alongclevis226.FIG. 25ais a cross-sectional view of one embodiment ofsurgical device210 taken along the longitudinal axis ofFIG. 25. Due to the profile ofslots258,270,top jaw218 andbottom jaw220 pivot about jaw pins260,261 and separate further from each other. As shown,top jaw218 andbottom jaw220 are nearly at a completely opened position. Furthermore,top pin286 has traveled nearly the full length offirst slot258, andbottom pin288 has traveled nearly the full length offirst slot270. Similarly,second jaw pin261 has traveled nearly the full length ofsecond slot259, andfirst jaw pin260 has traveled nearly the full length ofsecond slot271.

FIG. 26 shows an embodiment ofsurgical device310. In various embodiments,surgical device310 may have atop jaw318 and abottom jaw320 pivotally coupled to aclevis326. As illustrated,top jaw318 may house atop electrode322 andbottom jaw320 may house abottom electrode328. Acoupling330 may allow for the attachment ofclevis26 to ashaft316. In various embodiments coupling330 may be optionally configured to allow thesurgical device310 to rotate relative to and about a longitudinal axis “D”, thus allowingsurgical device310 to be positioned in multiple angular orientations. Some embodiments may havemultiple couplings330. Optionally,surgical device310 may, for example, be attached to a laparoscopic and endoscopic instrument. Accordingly, in various embodiments,shaft316 may be either flexible or rigid, or a combination thereof. Adriveline332 is located insideshaft316. In various embodiments,driveline332 passes through the center ofcoupling330 and is attached toslider324.Driveline332 may be coupled toslider324 using any suitable means, such as laser welding.Slider324 functions to slide on longitudinal axis “D.”

As shown inFIGS. 26a-b,surgical device310 is configured for electrical therapy ablation, but in other embodiments may be configured for cutting, dissecting, or grasping. For example,top jaw318 andbottom jaw320 may be configured with cutting blades, a plurality of teeth, or any other configuration providing the required functionality. It is understood by those skilled in the art thatsurgical device310 can be coupled to any control device, mechanical or electrical, which allows for actuation oftop jaw318 andbottom jaw320, such ashandle assembly14 shown inFIG. 2.

FIG. 27ashows a perspective view ofbottom jaw320 of one embodiment ofsurgical device310. Jaw may include a plurality of teeth (not shown).Jaw320 also may housebottom electrode328 and abottom insulator329. Arear fin354 may define afirst hole356 and asecond hole358.First hole356 andsecond hole358 are suitable to receive afirst jaw pin360 and second jaw pin361 (FIG. 26a). In various embodimentsfirst jaw pin360 may be unitary or integral withbottom jaw320. Similarly, in various embodiments, embodimentssecond jaw pin361 may be unitary or integral withbottom jaw320. In the illustrated embodiment ofbottom jaw320 shown inFIG. 27b,rear fin354 comprises a recessedsection355. Recessedsection355 may include apin357 protruding from the recessed section. In various embodiments, pin357 may be unitary withrear fin354 or, in various embodiments, pin357 may be a member inserted into a hole.

FIG. 28ashows a perspective view oftop jaw318 of one embodiment of thesurgical device310.Top jaw318 is constructed similarly tobottom jaw320.Jaw318 may include a plurality of teeth (not shown).Jaw318 also may housetop electrode322 and atop insulator323. Arear fin366 may define afirst hole368 and asecond hole370.First hole368 andsecond hole370 are suitable to receive afirst jaw pin312 and a second jaw pin314 (FIG. 26b). In various embodiments the jaw pins may be unitary or integral withbottom jaw320. As shown inFIG. 28b, in various embodiments,top jaw318 may comprise apin359 protruding fromrear fin366. In various embodiments, pin359 may be unitary withrear fin366 or, in various embodiments, pin359 may be a member inserted into a hole.

As shown inFIGS. 29a-b,slider324 may havetop flanges336a,336bandbottom flanges338a,338bextending from either side ofslider324.Top flange336aandbottom flange338aonfirst side340 define afirst channel341, andtop flange336bandbottom flange338bdefine asecond channel342 onsecond side344.First side340 andsecond side342 also may define afirst hole346 andsecond hole348, respectively.First hole346 andsecond hole348 are suitable to receive aslider pin347 and aslider pin348, respectively (FIGS. 30a-b). In various embodiments,slider324 may be positioned insurgical device310 such thatclevis326 is received byfirst channel341 andsecond channel342. As described in more detail below,slider324 functions to slide on longitudinal axis “D”, as shown inFIG. 26, alongclevis326.Top flanges336a,336bandbottom flanges338a,338bkeepslider324 generally affixed to clevis326 while allowing for axial movement. Sincedriveline332 is coupled toslider324, the actuation oftrigger82 also serves to moveslider324. Therefore, movement of trigger82 (FIG. 2) is translated into longitudinal movement ofslider324 alongclevis326.

FIGS. 30a-cillustrate an embodiment oflinkage380. In various embodiments,linkage380 may be comprised of afirst link382 and asecond link384. First link382 may connectslider324 tobottom jaw320 andsecond link384 may connectslider324 totop jaw318. In some embodiments,linkage380 may comprise additional components. As shown inFIG. 30cfirst link382 may define afirst hole386 and asecond hole388. Similarly,second link384 may define afirst hole390 and asecond hole392.Links382 and384 may be any suitable shape. Examples of suitable shapes may include oblong, rectangular, or rod-like. In variousembodiments slider pin347 may be received insecond hole388 andslider pin348 may be received bysecond hole392.Pin357 may be received byfirst hold386 and pin359 may be received byfirst hole390.

FIGS. 31a-billustrates a perspective view an embodiment ofclevis326 from two different angles.Clevis326 has adistal end400 and aproximal end402.Proximal end402 may be configured to couple tocoupling330. In various embodiments,distal end400 might define afirst hole404 and asecond hole406. In various embodiments a pin (not shown) may be placed throughfirst hole404 and second406 to reduce movement offirst side408 relative tosecond side410 during operation ofsurgical device310.Clevis326 may have afirst side408 extending fromproximal end402 and asecond side410 extending fromproximal end402. In various embodiments,first side408 andsecond side410 may be substantially parallel.First side408 may define aslot412 andsecond side410 may define agroove414 for housing conductors.

Distal end offirst side408 may comprise a plurality of slots. In the illustrated embodiment,first side408 comprises afirst slot416 and a second slot, comprised offirst section418aandsecond section418b. An exemplary embodiment offirst slot416,first section418a, andsecond section418bare illustrated inFIG. 32a. The longitudinal axis “A1” offirst section418amay be substantially parallel to longitudinal axis “A2” offirst slot416. Axis A1 and A2 may in positioned in an angular relationship to longitudinal axis “E”, the angular relationship identified by angle θ₁.Second section418bdiverges fromfirst section418aat an angle θ₂. In various embodiments,second section418bmay be curved. In some embodiments,second section418bmay have a curvature with a radius “r,” which converges on apoint420.First jaw pin360 may be configured to engage and travel along the path defined byfirst section418aandsecond section418b.Second jaw pin361 may be configured to engage and travel along the path defined byfirst slot416.

Distal end ofsecond side410 may comprise a plurality of slots. In the illustrated embodiment,second side410 comprises afirst slot422 and a second slot, comprised offirst section424aandsecond section424b. An exemplary embodiment offirst slot422,first section424a, andsecond section424bare illustrated inFIG. 32b. The longitudinal axis “B1” offirst section424amay be substantially parallel to longitudinal axis “B2” offirst slot422. Axis B1 and B2 may be positioned in an angular relationship to longitudinal axis “E”, the angular relationship identified by angle θ₁.Second section424bdiverges fromfirst section424aat an angle θ₂. In various embodiments,section424bmay have a curvature with a radius “r,” which converges on apoint426.Second jaw pin314 may be configured to engage and travel along the patent defined byfirst section424aandsecond section424b.First jaw pin312 may be configured to engage and travel along the path defined byfirst slot422.

FIGS. 33-35 demonstrate a progression of the actuation ofsurgical device310. Referring first toFIG. 33,surgical device310 is shown in a “closed position.” In its closed position,top jaw318 andbottom jaw320 are in close proximity to each other, allowing for the cutting, grasping, or ablating of tissue. In the illustrated embodiment,first jaw pin360 andsecond jaw pin361 are located near the proximal end offirst section418aandfirst slot416, respectively. In order to actuate, or open,top jaw318 andbottom jaw320, the user may impart movement todriveline332. In various embodiments, trigger82 may be used to impart such movement. Sinceslider324 is coupled todriveline332, movement ofdriveline232 in afirst direction372 movesslider324 longitudinally infirst direction372, or toward the distal end ofsurgical device310.FIG. 33ais a cross-sectional view of one embodiment ofsurgical device310 taken along the longitudinal axis ofFIG. 33.

FIG. 34 shows the position oftop jaw318 andbottom jaw320 afterslider324 andlinkage380 have moved infirst direction372. By virtue of the movement ofdriveline332,slider324 has been moved longitudinally alongclevis326.Slider324 may be coupled tofirst link382 and asecond link384 which are coupled totop jaw318 andbottom jaw320, respectively. Thus, movement ofslider324 infirst direction372 movesfirst jaw pin360 andsecond jaw pin361 distally along the paths defined byfirst section418aandfirst slot416, respectively. Movement ofslider324 infirst direction372 also movesfirst jaw pin312 andsecond jaw pin314 distally along the paths defined byfirst slot422 andfirst section424a, respectively. Due to the profile offirst section418a,first slot416,first slot422, and424a,top jaw318 andbottom jaw320 separate from each other in a direction indicated byarrows429 while remaining substantially parallel.FIG. 34ais a cross-sectional view of one embodiment ofsurgical device310 taken along the longitudinal axis ofFIG. 34.

FIG. 35 shows the position oftop jaw318 andbottom jaw320 afterslider324 andlinkage380 have moved further infirst direction372.Slider324 has been moved longitudinally further alongclevis326. Due to the profile offirst section418a,first grove416,first grove422, and424a,top jaw318 andbottom jaw320 separate further from each other in a direction indicated byarrows429 while remaining substantially parallel. Furthermore,second jaw pin361 has traveled nearly the full length of the path defined byfirst grove416, andfirst jaw pin360 has traveled nearly the full length of the path defined byfirst section418a. Similarly,first jaw pin312 has traveled nearly the full length of the path defined byfirst grove422 andsecond jaw pin314 has traveled nearly the full length of the path defined byfirst section424a.FIG. 35ais a cross-sectional view of one embodiment ofsurgical device310 taken along the longitudinal axis ofFIG. 35.

FIG. 36 shows the position oftop jaw318 andbottom jaw320 afterslider324 andlinkage380 have has moved further infirst direction372.Slider324 has been moved longitudinally further alongclevis326.First jaw pin360 is located in the path defined bysecond section418b.Second jaw pin314 is located in the path defined bysecond section424b. Asslider324 is moved infirst direction372,first jaw pin360 pivots aboutsecond jaw pin361 andsecond jaw pin314 pivots aboutfirst jaw pin312. Asfirst jaw pin360 andsecond jaw pin314 pivot,top jaw318 andbottom jaw320 angularly separate from each other the direction indicated byarrows430.FIG. 36ais a cross-sectional view of one embodiment ofsurgical device310 taken along the longitudinal axis ofFIG. 36.

FIG. 37 shows the position oftop jaw318 andbottom jaw320 afterslider324 andlinkage380 have has moved further infirst direction372.Slider324 has been moved longitudinally further alongclevis326.First jaw pin360 is located near the distal end of the path defined bysecond section418b.Second jaw pin314 is located near the distal end of the path defined bysecond section424b.First jaw pin360 has pivoted further aboutsecond jaw pin361 andsecond jaw pin314 has pivoted further aboutfirst jaw pin312.Top jaw318 andbottom jaw320 have angularly separated further from each other the direction indicated by430 to achieve a fully opened position.FIG. 37ais a cross-sectional view of one embodiment ofsurgical device310 taken along the longitudinal axis ofFIG. 37.

An exemplary procedure for use withsurgical device310 is illustrated inFIGS. 38-40. It will be appreciated by those skilled in the art that the methods described are also applicable to other embodiments or devices. After approaching an organ or tissue, such asartery431,surgical device310 is actuated to separatetop jaw318 andbottom jaw320 so that the target, illustrated asartery431, may be received between the jaw members (FIG. 38).Top jaw318 andbottom jaw320 are then “closed” to clampartery431 betweentop electrode322 andbottom electrode328. Astop jaw318 andbottom jaw320 close indirection432, they change from having an angular relationship (FIG. 38) to having a substantially parallel relationship (FIG. 39). Thus,top jaw318 andbottom jaw320 are able to engageartery430 while in a substantially parallel position. As shown, the artery may be clamped bytop jaw318 andbottom jaw320 to enable good contact with the ablation surfaces and an even distribution of electrical energy. Clamping also helps to remove blood from the tissue.

As appreciate by those skilled in the art, the pivoting configuration oftop jaw318 andbottom jaw320 allows for atop electrode322 andbottom electrode328 to be in a parallel arrangement, even if thetop jaw318 andbottom jaw320 are not in a fully “closed” position. Ablation energy is more effectively delivered to tissue iftop electrode322 andbottom electrode328 are in a parallel arrangement. Thus,surgical device310 can grip tissue and deliver energy to the tissue while the electrodes are in a parallel arrangement, even though thetop jaw318 andbottom jaw320 are separated from each other. After energy has been delivered to thetop electrode322 andbottom electrode328 by any suitable technique,top jaw318 andbottom jaw320 ofsurgical device310 may be opened and removed from theablation sight434 ofartery431.

The devices disclosed herein can be designed to be disposed of after a single use, or they can be designed to be used multiple times. In either case, however, the device can be reconditioned for reuse after at least one use. Reconditioning can include any combination of the steps of disassembly of the device, followed by the cleaning or replacement of particular pieces, and subsequent reassembly. In particular, the device can be disassembled, and any number of the particular pieces or parts of the device can be selectively replaced or removed in any combination. Upon the cleaning and/or replacement of particular parts, the device can be reassembled for subsequent use either at a reconditioning facility or by a surgical team immediately prior to a surgical procedure. Those skilled in the art will appreciate that the reconditioning of a device can utilize a variety of techniques for disassembly, cleaning/replacement, and reassembly. The use of such techniques, and the resulting reconditioned device, are all within the scope of the present application.

Preferably, the various embodiments described herein will be processed before surgery. First, a new or used instrument is obtained and, if necessary, cleaned. The instrument can then be sterilized. In one sterilization technique, the instrument is placed in a closed and sealed container, such as a plastic or TYVEK® bag. The container and instrument are then placed in a field of radiation that can penetrate the container, such as gamma radiation, x-rays, or high-energy electrons. The radiation kills bacteria on the instrument and in the container. The sterilized instrument can then be stored in the sterile container. The sealed container keeps the instrument sterile until it is opened in the medical facility. It is preferred that the device is sterilized. This can be done by any number of ways known to those skilled in the art, including beta or gamma radiation, ethylene oxide, or steam.

Although the various embodiments have been described herein in connection with certain disclosed embodiments, many modifications and variations to those embodiments may be implemented. For example, different types of end effectors may be employed. Also, where materials are disclosed for certain components, other materials may be used. The foregoing description and following claims are intended to cover all such modifications and variations.

Any patent, publication, or other disclosure material, in whole or in part, that is said to be incorporated by reference herein is incorporated herein only to the extent that the incorporated material does not conflict with existing definitions, statements, or other disclosure material set forth in this disclosure. As such, and to the extent necessary, the disclosure as explicitly set forth herein supersedes any conflicting material incorporated herein by reference. Any material, or portion thereof, that is said to be incorporated by reference herein, but which conflicts with existing definitions, statements, or other disclosure material set forth herein will only be incorporated to the extent that no conflict arises between that incorporated material and the existing disclosure material.

Claims (26)

What is claimed is:

1. A surgical device comprising:

a clevis defining a longitudinal axis, wherein the clevis comprises a first prong and a second prong;

a jaw comprising a first member and a second member, wherein the first member comprises a first slot, a third slot, and a first member pin, wherein the second member comprises a second slot, a fourth slot, and a second member pin, wherein the first member pin is receivably engaged in the second slot, and wherein the second member pin is receivably engaged in the first slot; and

a slider slidably engaged to the clevis, the slider comprising:

a first channel on a first lateral side of the clevis;

a second channel on a second lateral side of the clevis, wherein the first channel is configured to receive a portion of the first prong of the clevis and the second channel is configured to receive a portion of the second prong of the clevis, and wherein the first and second prongs of the clevis guide longitudinal movement of the slider therebetween; and

a plurality of slider pins, wherein each slider pin of the plurality of slider pins is receiveably engaged in one of the third slot and the fourth slot, wherein the jaw is selectively moveable between a first position and a second position through longitudinal movement of the slider, and wherein the surgical device is dimensioned to be inserted through a working channel of an endoscope.

2. The surgical device ofclaim 1, wherein the jaw comprises a cutting element.

3. The surgical device ofclaim 1, wherein the first fourth slot and the third slot are linear.

4. The surgical device ofclaim 1, wherein the first slot and the second slot are non-linear.

5. The surgical device ofclaim 1, wherein a driveline is coupled to the slider.

6. The surgical device ofclaim 5, comprising:

a handle portion to receive a proximal end of the driveline;

a trigger operatively coupled to the driveline;

wherein the trigger is pivotally moveable in a first rotational direction to move the driveline in the first direction to open the jaw; and

wherein the trigger is pivotally moved in a second rotational direction to move the driveline in the second direction to close the jaw.

7. A surgical device comprising:

a clevis defining a longitudinal axis, wherein the clevis comprises a first clevis side and a second clevis side;

a jaw comprising a first member and a second member, the first member defining a first slot and a third slot and the second member defining a second slot and a fourth slot; and

a slider slidably engaged to the clevis, the slider comprising:

a first channel on a first lateral side of the slider, wherein the first channel is configured to receive the first clevis side;

a second channel on a second lateral side of the slider, wherein the second channel is configured to receive the second clevis side, and wherein the first and second clevis sides guide longitudinal movement of the slider therebetween;

a first pin; and

a second pin, wherein the first pin is receiveably engaged in the third slot, wherein the second pin is receivably engaged in the fourth slot, and wherein the jaw is selectively moveable between a first position and a second position through longitudinal movement of the slider, wherein the surgical device is dimensioned to be inserted through a working channel of an endoscope.

8. The surgical device ofclaim 7, comprising:

a driveline coupled to the slider;

a handle portion to receive a proximal end of the driveline;

a trigger operatively coupled to the driveline; and

wherein the trigger is pivotally moveable in a first rotational direction to move the driveline in the first direction to open the jaw; and is pivotally moved in a second rotational direction to move the driveline in the second direction to close the jaw.

9. The surgical device ofclaim 8, wherein the slider is moved in a direction toward the distal end of the surgical device to open the jaw and the slider is moved in a direction toward the proximal end of the surgical device to close the jaw.

10. The surgical device ofclaim 9, wherein the first slot is non-linear.

11. The surgical device ofclaim 10, wherein the second slot is non-linear.

12. A surgical device comprising:

a clevis defining a longitudinal axis, wherein the clevis comprises a first pronged portion and a second pronged portion;

a jaw comprising a first member and a second member, wherein the first member comprises a first slot and a third slot, and wherein the second member comprises a second slot and a fourth slot;

a slider slidably engaged to the clevis, the slider comprising:

a first channel and a second channel, wherein the first channel is positioned on a first lateral side of the clevis and is configured to receive the first pronged portion, wherein the second channel is positioned on a second lateral side of the clevis and is configured to receive the second pronged portion, and wherein the first and second pronged portions of the clevis guide longitudinal movement of the slider therebetween; and

a first pin and a second pin, wherein the third slot of the first member receives the first pin, and wherein the fourth slot of the second member receives the second pin;

a driveline coupled to the slider, wherein the jaw is selectively moveable between a first position and a second position through longitudinal movement of the driveline;

a handle portion to receive a proximal end of the driveline;

a trigger operatively coupled to the driveline;

wherein the trigger is pivotally moveable in a first rotational direction to move the driveline in the first direction to open the jaw; and

wherein the trigger is pivotally moved in a second rotational direction to move the driveline in the second direction to close the jaw.

13. The surgical device ofclaim 12, wherein first and second electrode portions are coupled to the first member and a second member, and wherein the first and second electrode portions are adapted to receive an electrical waveform.

14. The surgical device ofclaim 13, wherein an electrical waveform generator is coupled to the first and second electrode portions and the first and second electrode portions are adapted to receive an electrical waveform.

15. The surgical device ofclaim 14, wherein the first slot is non-linear.

16. The surgical device ofclaim 15, wherein the second slot is non-linear.

17. A surgical instrument comprising:

a housing, the housing dimensioned to be inserted through a working channel of an endoscope, wherein the housing comprises a longitudinal axis, a first slot, a second slot, a third slot, and a fourth slot, wherein the first, second, third, and fourth slots are elongate in the direction of the longitudinal axis, and a portion of the first slot is parallel to a portion of the second slot and wherein a portion of the third slot is parallel to a portion of the fourth slot; and

a jaw comprising a first member, a second member, and an electrode, the jaw pivotally connected to the housing, wherein the first jaw comprises a first pivot pin and a second pivot pin and wherein the second jaw comprises a third pivot pin and fourth pivot pin, wherein the first pin is received by the first slot, the second pin is received by the second slot, the third pin is received by the third slot, and the fourth pin is received by the fourth slot,

wherein the jaw is selectively movable between a first position, a second position, and a third position, wherein the first member and second member are substantially parallel in the first position and substantially parallel in the second position, and wherein the first member and second member are configured in an angular relation in the third position.

18. The surgical instrument ofclaim 17, further comprising an actuator, wherein the first member and the second member are operably engaged with the actuator such that, when the actuator is moved relative to the housing, the first jaw member and the second jaw member are moved between the first, second, and third positions.

19. The surgical instrument ofclaim 18, wherein the jaw further comprises a second electrode.

20. The surgical instrument ofclaim 19, further comprising a switch, wherein the switch is selectively operable to place at least one of the first electrode and the second electrode in electrical communication with an electric current source.

21. The surgical instrument ofclaim 20, wherein the first slot has a curved portion and the third slot has a curved portion.

22. The surgical instrument ofclaim 21, wherein the first jaw and the second jaw are in the third position when the first pin is located in the curved portion of the first slot and the third pin is in the curved portion of the third slot.

23. The surgical instrument ofclaim 17, wherein the first position is a closed position, and wherein the third position is an open position.

24. A surgical instrument, comprising:

a hand piece;

a shaft;

a housing dimensioned to be inserted through a working channel of an endoscope wherein the housing comprises a longitudinal axis, a first slot, a second slot, a third slot, and a fourth slot, wherein the first, second, third, and fourth slots are elongate in the direction of the longitudinal axis; and

a grasping device pivotally connected to the housing, comprising:

a first jaw including a first electrode, a first pin, and a second pin, wherein the first slot receives the first pin and the second slot receives the second pin;

a second jaw including a second electrode, a third pin, and a fourth pin, wherein the third slot receives the third pin and the fourth slot receives the fourth pin, wherein the second jaw is selectively movable between an angular open position, a parallel open position, and a parallel closed position.

25. The surgical instrument ofclaim 24, further comprising an actuator, wherein the first jaw member and the second jaw member are operably engaged with the actuator such that, when the actuator is moved relative to the shaft, the first jaw member and the second jaw member are pivoted between the angular open position, the parallel open position, and the parallel closed position.

26. The surgical instrument ofclaim 25, wherein the shaft is a flexible shaft.

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